Evaluation Of Doctors' Adherence To Medication Recommendations Of Clinical Practice Guidelines On Management Of Hypertension (CPG 2008) At Hospital Pulau Pinang
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Date
2012-03
Authors
Ahmad, Nafees
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
The existing literature suggests that doctors’ divergence from guidelines is one of the major contributing factors for poor control of hypertension. The present research in which 26 doctors were enrolled was cross sectional study conducted at Hospital Pulau Pinang (HPP). Its aim was to evaluate doctors’ knowledge, attitude and practice of Malaysian clinical practice guidelines on the management of hypertension CPG (2008), and factors associated with guidelines’ adherence and hypertension control. Doctors’ knowledge and attitudes on CPG (2008) were evaluated through a questionnaire. Prescriptions written by 26 enrolled doctors to 650 established hypertensive outpatients (25 prescriptions per enrolled doctor with 25% drop out rate) were noted on visit one along with patients’ demographic and clinical data. The noted prescriptions were classified either as adherent or non adherent to CPG (2008). Five hundred and twenty (80%) of the enrolled patients (20 patients per enrolled doctor) were followed for one more visit. Blood pressure (BP) noted on visit 2 was related to the prescription written on visit one. SPSS 16 was used for data analysis. A p-value <0.05 was considered statistically significant. Nineteen doctors (73.07%) had adequate knowledge of CPG (2008). Group composed of specialists and consultants had significantly better knowledge of CPG (2008) than medical officers (p-value <0.001). Doctors were highly positive towards CPG (2008) with mean attitude score of 23.15+1.34 points, ranging from 19-24 points on a 30 point scale. Statistically significant strong positive correlation
(rs= 0.635, p-value <0.001) was observed between doctors’ knowledge and practice scores.
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Keywords
Evaluation of doctors' adherence to medication recommendations , clinical practice guidelines on management of hypertension